The Vendor Registration Application form is an interactive form that will be completed by an Ontario retailer or supplier of home oxygen therapy who is requesting registration with the Assistive Devices Program.
Form completed by clients to record their wishes for organ/tissue donation
Form is generated by client communication system to have people come in to renew photo health card
Form used so patient can submit out of country medical receipts
Form outlines the Conformance Testing-Acceptable Use Policy and is part of agreement between ministry and vendor who must successfully pass the conformance testing.
This form is to be used for a patient who is seeking a reduction to the co-payment or for whom a reduction is sought further to the factors set out in section 10 of Reg. 552 under the Health Insurance Act.
form used for out-patient services incurred by visitors from another province
Form used as part of EDT registration package for IHPs
Form to show all group locations where physician services provided
form sent to other provinces for reimbursement of inpatient claims paid (reciprocal)
This form is completed by the person in charge of the secure treatment program once the criteria are met for the child's emergency admission to a secure treatment program.
form used so physicians can have direct deposit of payment of claims
form submitted with claims to provide additional information regarding particular claim
Form is generated by client communication system to have people replace red&white card with photo health card
User Agreement for Pharmacies Requesting Publicly Funded Influenza Vaccine in accordance with the UIIP Prequalification form for health care agencies and workplaces that are required to prequalify in order to receive influenza vaccine.
Application for drug funding
Requisition for Naloxone
Authorizer Application - Attachment B
